Pancreatitis acute: first emergency aid

Types of acute pancreatitis

Acute pancreatitis is divided into acute interstitial pancreatitis, or acute edemaodnozhdochnoy gland, acute hemorrhagic pancreatitis, acute pancreatic necrosis and acute purulent pancreatitis. As a special form, exacerbation of chronic pancreatitis is indicated.

Pain attack: symptoms and signs

Many patients have a precursor to the development of acute pancreatitis, there are the appearance of vague complaints, fuzzy pains in the epigastric region or in the navel, sometimes in the form of bile colic, rapidly passing dyspeptic phenomena, etc.

The disease begins with severe pain in thethe upper half of the abdomen is of a shingling nature. Pain in the left hypochondrium is characteristic for the defeat of the tail of the pancreas, pain along the middle line - for the destruction of the body, to the right of the middle line - the head of the gland, and pain of the surrounding nature indicates total inflammation of the pancreas.

A painful attack is often preceded by the use of alcohol, fatty foods, overeating. In the anamnesis there may be an indication of cholelithiasis. Because of severe pain, patients are restless and constantly change their position without getting relief. With the onset of necrosis of nerve endings, the intensity of pain decreases. Irritation of the diaphragm leads to the appearance of hiccups.

Nausea and vomiting are the second leading symptom of acute pancreatitis. Vomiting is often painful, indomitable, not bringing relief. The facial features are sharpened. Skin and mucous membranes are often pale, sometimes with a cyanotic hue. Shock phenomena may develop.

Quite often pancreatitis is accompanied by mechanical jaundice. Pulse only at the very beginning of the disease can not be accelerated( sometimes even bradycardia), soon there is a tachycardia( from 100 to 140 beats per minute), blood pressure decreases.

Pathognomonic signs of destructive pancreatitis - areas of cyanosis of the skin or subcutaneous hemorrhages around the navel, on the lateral areas of the abdomen, anterior abdominal wall, face.

Patients spare the stomach with breathing, which is slightly inflated, especially at the top. At the beginning of the disease, muscle tension and the Shchetkin-Blumberg symptom are absent. There is only some resistance of the abdominal wall in the epigastric region.

Palpation of pain corresponds to the location of the pancreas.

Sometimes there is soreness also in the left pancreatic corner. When auscultation of the abdomen is usually noted weakening of peristalsis. Progression of the painful process, especially the transition of pancreatitis to the necrotic stage, leads to the appearance of signs of peritonitis: a pronounced tension of the abdominal muscles, a positive symptom of Shchetkin-Blumberg.

Body temperature in acute pancreatitis is usually normal or slightly elevated. Leukocytes are usually within 8.10-15.10 / l, but in a number of patients it reaches 20.10 / l and even 30.10 / l. The content of diastase in the urine( the norm of 16-64 units) rises already after 2-3 and after the onset of the disease.

However, with total pancreatic necrosis, an increase in the level of diastase may be absent.

The normal level of diastase can also be preserved when exacerbation of chronic pancreatitis, which is the cause of atrophy of the glandular apparatus.

Diagnosis

Differential diagnosis is performed with acute cholecystitis( see), perforated gastroduodenal ulcer( see), thrombosis of mesenteric vessels( see), renal colic( see), acute gastritis, myocardial infarction. It must also be remembered that the disease often takes place in the form of acute cholecysto-pancreatitis.

In difficult for diagnosis cases, an instrumental examination in a hospital environment is necessary.

First emergency care

Emergency care and hospitalization. All patients with acute pancreatitis or with suspicion of it are subject to emergency hospitalization in a surgical hospital.

At the pre-hospital stage, the events are aimed at combating severe pain syndrome and arterial hypotension, ie, they include elements of infusion therapy( polyglucin, hemodez, etc.), as well as the appointment of cardiac glycosides, analeptics, respiratory stimulants, analgesics( other than drugs).

Before and during transport, 1 ml of 0.1% solution of atropine is injected subcutaneously, intramuscularly 2 ml of 2% solution of papaverine, with very severe pain intramuscularly injected 1 ml of a 50% solution of analgin. Early, from the moment of diagnosis of acute pancreatitis, the use of antispasmodics allows a 2-fold decrease in the number of necrotic forms of the disease.

The main method of treating acute pancreatitis is conservative.

Cholecystopancreatitis with destruction of the gallbladder or bile ducts, an increase in pronounced peritonitis, purulent pancreatitis and pancreatic necrosis, with the progression of a life-threatening collapse, with unsuccessful conservative treatment, are subject to surgical treatment.

Related videos

Elena Malysheva: symptoms of pancreatitis, first aid

In this issue of the TV program "Live healthy!" With Elena Malysheva you will learn about the signs of acute pancreatitis.

Acute pancreatitis is an inflammation of the pancreas.

The pancreas secretes enzymes necessary for digestion. When the food enters the stomach, the pancreas secretes the juice that enters the intestine, where the digestion process ends. The intestinal mucosa protects its walls, as well as the rest of the organs from the effects of enzymes.

In acute pancreatitis, enzymes enter the pancreas and begin to erode, which causes inflammation and severe pain, which decreases if the person lies in the fetal position. In addition, enzymes can begin to destroy blood vessels and other tissues and cause pancreatic necrosis - necrosis of pancreatic tissue.

Causes of acute pancreatitis

1. Alcohol and fatty foods. With excessive consumption of alcohol and fatty foods, the pancreas becomes inflamed, increases, and acute pancreatitis can occur.
2. Gallstone disease. The gallbladder and pancreas have a common duct. When a person eats fatty foods, a large amount of bile is produced, and the stone can exit the gallbladder and block the common duct. As a result, the pressure in the duct of the pancreas rises, the vessels can burst, and the enzymes begin to erode the pancreas and surrounding tissues.

What to do if you have acute pancreatitis

1. If you have pancreatitis, do not eat and call an ambulance urgently.
2. In acute pancreatitis relieve pain syndrome and remove toxins from the body with a large amount of water. In especially severe cases, acute pancreatitis is treated surgically.

Avoiding acute pancreatitis

1. For pancreatic diseases, do not consume alcohol and do not overeat.
2. Timely treatment of cholelithiasis.

Acute pancreatitis: signs, emergency care

Acute pancreatitis is a lecture. Plyusnin Boris Ivanovich - doctor of medical sciences, professor. Video lectures are provided by the Department of Faculty Surgery No. 2( moshirurg.ru) of the Moscow State Medical and Dental University.

Pancreatitis: folk recipes

Video about what pancreatitis is. Folk recipes. What can and should be eaten with pancreatitis.

Source of the : Eliseev OM.(compiler).A guide to emergency and emergency care.- SPb.: Izd. Leyla LLP, 1996